Is there anything that can be done to raise incisions once they are made? I feel they may be too low. (Photo)

My crease was lowered by my ps unknowingly to me. It seems he made my incisions so low that now I am asking for a revision to move my implants up but there is only 2cm of room from my fold to my incisions. I obviously dont want my incisions to show below my fold. What options do I have, if any? My ps plans to bring them up right to the incisions but I am afraid thats not enough. Part of me wonders if he should have used my original breast fold?

Doctor Answers 11

Breasts are settled below the incisions

I agree that you will need a revision to bring the fold of the breasts up to the level of the incisions.  I wouldn't go higher than that, but as one would always say a full examination will always be required to evaluate this.  This elevation should be able to be accomplished by a well trained board certified Plastic Surgeon.
Good luck to you.
Frank Rieger M.D.  Tampa Plastic Surgeon

The best option for you is fortunately one that will "kill 3 birds with one stone!"

The things you have mentioned that you don't like about your breasts are all the result of essentially the same process.  In the time since your surgery, your tissues did not support the implants, and they migrated downward toward your abdomen.  Some refer to this as "bottoming out," and it is fairly common if measures aren't taken to control it.  The things that you are seeing that are the result of this implant displacement are the upward migration of the scar, the lowering of the inframammary fold beyond where the surgeon originally lowered it, and the off-center position of the nipples.  Once bottoming out occurs, there really is only one way to deal with it, but fortunately it is pretty effective the first time around.  Capsulorrhaphy is typically performed, and this involves tightening up, or shortening, the excessively long lower pole capsule.  Regarding the original lowering of the fold and placement of the incisions, it is difficult to comment on that exactly, not knowing what size your implants are and how the surgeon marked your implant or incision position.   However, I can tell you almost unequivocally from looking at your before and after pictures, that the inframammary fold needed to be lowered somewhat to accommodate the size of the implants.  This makes sense if you consider that your new, larger breasts would have a longer distance from the fold to the nipple simply because the curvature is greater than that of your smaller natural breasts.  Failure to do that would most likely have resulted in the implants being positioned too high for the nipples, as your lower pole arc length would then be too short for the new breasts, and you wouldn't have liked that either.  This points out the value of using internal sutures to stabilize the implant position at the time of the original augmentation if the fold is lowered.  It is understandable that you don't want your scars to be below the inframammary fold, and that is really what the goal should be, but it appears from your day 39 image that there should be enough room for a reasonable capsulorrhaphy given the size of your implants to correct the problem and still leave the scar at or slightly above the fold.  Again, your surgeon will be the best one to make final determinations about the planning of this, but if you would feel more comfortable seeking a second opinion from a surgeon in your area who can examine you in person and give you a good assessment of this, I think it is reasonable to pursue that.  Good luck to you!

Revision surgery

Yes, you don't want your incisions to show. There are actually a number of ways that the implant can be repositioned. Make sure that your surgeon has a lot of experience in revision surgery. If not, you may want to seek a second opinion from another surgeon in your area who does.
My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Bottoming out

Hello,

Your implants appear to have bottomed out- well past the incision and crease. Revision to move the crease back up and secure it there will lift the implants back up to a proper position. You will need to discuss what this might do for your incision positioning.

All the best

Is there anything that can be done to raise incisions once they are made? I feel they may be too low.

As for incision placement not much to offer. But are you mis dx that you have bottoming?>>>>>>>>>>>>>>>>>

Is there anything that can be done to raise incisions once they are made? I feel they may be too low.

Thank you for your question and photograph.  I am sorry but your implants are bottoming out which is causing the nipple distortion.

You will need a revision of the breast implant pocket to restore your inframammary crease to the proper location near the fifth rib.  Results of this revision can be excellent if the procedure is done correctly.  Please see your plastic surgeon to discuss this  and if you do not receive a satisfactory response please seek a second opinion from a board certified plastic surgeon.

For more information please see the link below

Is there anything that can be done to raise incisions once they are made? I feel they may be too low.

Thank you for your question and I am sorry your results have not been what you anticipated.  What appears to have taken place is that your implants have settled too low onto your chest wall, causing an artificial elevation to your nipple, as well as your breast incisions.  I would recommend revising your results by tightening the lower border of your implant pocket to raise the implants on your chest wall, while also reducing the size of your implants to help prevent recurrence.  If you would like to stay at the same implant size, you may wish to consider the use of an internal bra scaffold to take the weight of your implants off of your skin to prevent this from occurring again.  Hope this makes sense. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Is there anything that can be done to raise incisions once they are made? I feel they may be too low.

I am not sure why your inframammary crease was lowered, at this point you have what is known as "bottoming out" and you need a revision procedure to elevate the fold and reposition your implants.

Mark Filstein, MD
New York Plastic Surgeon
4.5 out of 5 stars 28 reviews

Capsular repair and larger implants

Hello and thank you for your question. Your inframammary fold needs to be reset with a capsular repair inferiorly and this will help position your implants in a better position on your chest and also allow your nipples to be located in a better position where your implants more greatly project. Excess skin from your fold may also need to be excised to better secure your repair and improve your scar.  I am sorry that you have experienced this disappointment but the good news is that this problem can be easily remedied and give you a much more beautiful breast. Make sure so seek consultation with a board certified plastic surgeon with expertise in revision breast surgery and has great reviews for their work in aesthetic breast surgery. I hope this helps to answer your questions and don't hesitate to contact us if we can be of further assistance to you.

Sincerely,

Dr. Sean Kelishadi
@sskplasticsurgery on Instagram

Sean Kelishadi, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 22 reviews

Is there anything that can be done to raise incisions once they are made? I feel they may be too low.

I am sorry to hear about the problem (bottoming out) you are experiencing.  Capsulorraphy surgery is indicated to improve your outcome. This procedure will serve to improve the position of the breast implants on your chest wall, improve the position of the nipple/areola complexes on each breast mound, and better hide the inframammary scars. I would suggest that you make sure that your plastic surgeon has a significant/demonstrable experience helping patients with this type of revisionary breast surgery. Best wishes.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.